| NPI | 1134392095 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 0436488) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2012028958) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: KS 0436488) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2020-11-10 |