| NPI | 1962600890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-35610) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 04-35610) |
| 207R00000X Internal Medicine (Licence: KS 9406834) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2024-07-29 |