| NPI | 1316928179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MO DO36585) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: KS 05-25558) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2021-08-19 |