| NPI | 1386008746 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 73304)  | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 73304)  | 
| Enumeration Date | 2016-04-11 | 
| Last Update Date | 2022-06-07 |