| NPI | 1104821792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 11099) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 11099) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-01-06 |