| NPI | 1174584148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: KS 04-23206) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MO 2000160553) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MO 2000160553) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: KS 04-23206) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2013-02-06 |