NPI | 1205830270 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 0418488) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 35931) |
Enumeration Date | 2005-06-08 |
Last Update Date | 2017-01-17 |