| NPI | 1285840801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 30687) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-33688) | 
| 207L00000X Anesthesiology (Licence: MO 2009007677) | |
| Enumeration Date | 2007-05-14 | 
| Last Update Date | 2025-05-02 |