| NPI | 1467438010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2008002387) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 46649) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 0432870) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2023-11-20 |