| NPI | 1740660992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0011360) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: DE C1-0011360) |
| 207R00000X Internal Medicine (Licence: DE C1-0011360) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2019-06-11 |