| NPI | 1366087587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 78026) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 78026) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2023-12-04 |