| NPI | 1366785768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 67593) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 67593) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2021-09-01 |