| NPI | 1487655288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 66014-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 66014) |
| 207L00000X Anesthesiology (Licence: MN 104915) | |
| 207L00000X Anesthesiology (Licence: MN 53275) | |
| 207L00000X Anesthesiology (Licence: ND 12789) | |
| 207R00000X Internal Medicine (Licence: AZ 24936) | |
| 207R00000X Internal Medicine (Licence: IA 24936) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-11-30 |