| NPI | 1174623540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2003009757) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 04-29441) |
| 207L00000X Anesthesiology (Licence: KS 04-29441) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2026-01-05 |