| NPI | 1831147065 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2022001205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0431841) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-01-24 |