| NPI | 1376957498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2018033161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 05-40924) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-02-20 |