| NPI | 1972580256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME75839) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-112836) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-11-29 |