| NPI | 1619969862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 1157) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 101601) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2024-06-13 |