| NPI | 1295998987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2012011179) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-39197) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-05-02 |