| NPI | 1417935743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 34360) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 13100) |
| 207L00000X Anesthesiology (Licence: IN 01057223A) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-07-31 |