| NPI | 1073838983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-35455) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 56678) |
| 207L00000X Anesthesiology (Licence: VA 0101245288) | |
| Enumeration Date | 2010-04-03 |
| Last Update Date | 2018-03-17 |