| NPI | 1912002247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AK 4509) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2017031882) |
| 207L00000X Anesthesiology (Licence: NM MD2025-0306) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2025-04-17 |