| NPI | 1053686378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 61296-20) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 61296-20) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2022-07-21 |