| NPI | 1366860793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: VA 0102206800) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C2-0013160) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2025-05-14 |