| NPI | 1225011315 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 36786-21) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 007093) | 
| Enumeration Date | 2005-11-22 | 
| Last Update Date | 2024-12-03 |