| NPI | 1104808070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AK 4624) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY 6970A) |
| 207L00000X Anesthesiology (Licence: AZ 30104) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2007-07-08 |