| NPI | 1750524443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-46261) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2009012767) |
| Enumeration Date | 2009-04-12 |
| Last Update Date | 2024-07-19 |