| NPI | 1013915925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 27313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 27313) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-07-09 |