| NPI | 1073927653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2022029781) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 9408456) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2022-08-11 |