| NPI | 1457613622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2016011532) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 9407934) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2020-12-10 |