| NPI | 1679555494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 49090) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-30584) |
| 207L00000X Anesthesiology (Licence: MO 2004007001) | |
| 207L00000X Anesthesiology (Licence: IL 036-167122) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2023-11-29 |