| NPI | 1114908563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-24992) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO MD R3P74) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2007-07-08 |