| NPI | 1053307496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C10007449) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C10007449) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C1-0010198) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2015-04-21 |