| NPI | 1962575985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2014025105) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0547720) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2024-06-24 |