| NPI | 1972899441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD173311) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-37009) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2023-07-21 |