| NPI | 1932553708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-43795) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R75499) |
| 207L00000X Anesthesiology (Licence: MO 2020025695) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2026-04-20 |