| NPI | 1023077104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-259005) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2002010041) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2014-07-18 |