| NPI | 1083935639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DE C1-0011288) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 275070-01) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2021-08-01 |