| NPI | 1528055563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS011882) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C2-0007898) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2021-05-25 |