| NPI | 1396096632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS022543) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 94-09638) |
| 247200000X Technician, Other | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2023-05-30 |