| NPI | 1568993772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0025172) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD473898) |
| 208VP0000X (Licence: DE C1-0025172) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2026-02-12 |