| NPI | 1558504761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 60852) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 60852) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2021-04-06 |