| NPI | 1124096987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 0420559) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: KS 0420559) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: KS 0420559) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: KS 0420559) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |