| NPI | 1639147622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 0438292) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 104112) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-10-31 |