| NPI | 1770963761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 0445921) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 94-08624) |
| 207L00000X Anesthesiology (Licence: CA A161655) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2022-07-14 |