| NPI | 1881680726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 04-33111) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2004007492) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2019-10-09 |