| NPI | 1376962738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2018013617) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0440931) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2024-11-07 |