| NPI | 1790778587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 51782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 66415) |
| 207L00000X Anesthesiology (Licence: KS 04-22743) | |
| 207L00000X Anesthesiology (Licence: MO 2006001821) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2006001821) | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2023-08-08 |