| NPI | 1417004300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-32460) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD0000040132) |
| 207L00000X Anesthesiology (Licence: MO 2007013970) | |
| 207L00000X Anesthesiology (Licence: NE 26906) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2026-04-08 |