| NPI | 1104887470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 47374-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 47374-020) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2015-01-22 |