| NPI | 1053394684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 25912) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 25912-020) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2021-11-30 |