| NPI | 1710335112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 2851) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 94-08894) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2023-04-13 |