| NPI | 1679685838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 04-37874) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2025000987) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-30 |