| NPI | 1629070529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 4872-320) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 8626) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2025-01-08 |