| NPI | 1740556992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AK 128515) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AK 128515) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AK 128515) | |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2020-08-28 |