| NPI | 1720209331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N6600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 6510) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-07-15 |