| NPI | 1285615450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO MD117295) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 04-27889) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2021-08-19 |