| NPI | 1205854932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 7516) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 85047-20) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-01-14 |