| NPI | 1720600604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0073416) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 94-10206) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2025-02-05 |