| NPI | 1124258702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 0437943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 37943) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2021-12-09 |