| NPI | 1619125572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 64954) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 57090) |
| 207L00000X Anesthesiology (Licence: MN 106959) | |
| 207L00000X Anesthesiology (Licence: IL 036130590) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2023-07-14 |