| NPI | 1730175399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0007252) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C10007252) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD420999) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2012-05-29 |