| NPI | 1255832762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 72402-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101275609) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2025-03-20 |