| NPI | 1639462328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2015013978) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 94-07633) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2021-09-27 |