| NPI | 1003827403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 09592) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101036233) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-08-02 |