| NPI | 1730394610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-37740) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007010296) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2026-04-08 |