| NPI | 1972999811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2019022217) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-42294) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2019-07-17 |