| NPI | 1245658715 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: KS 0442240) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2014019476) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 59705) | |
| 207L00000X Anesthesiology (Licence: MN 59705) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2023-10-16 |