| NPI | 1679789010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: PA OS014022) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS014022) |
| 207L00000X Anesthesiology (Licence: PA OS014022) | |
| 208VP0000X (Licence: DE C2-0012281) | |
| 208VP0000X (Licence: MD H0091267) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2023-05-04 |