| NPI | 1083271977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 123750) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 97271) |
| Enumeration Date | 2019-05-26 |
| Last Update Date | 2019-07-15 |