| NPI | 1336344928 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 86153-20) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 69909) | 
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 69909) | |
| Enumeration Date | 2007-06-15 | 
| Last Update Date | 2025-09-05 |