| NPI | 1164628418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX W1713) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-35744) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2025-12-01 |