| NPI | 1356513006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 57318-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 49740) |
| 207L00000X Anesthesiology (Licence: CO 2549) | |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2021-12-29 |