| NPI | 1255892055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2019022843) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-48696) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-09-16 |