| NPI | 1245227198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 34800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 57978) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME78192) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2019-06-18 |