| NPI | 1366937674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2018022808) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS FB3136050) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2025-04-18 |