| NPI | 1124032917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 24121) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D69151) |
| 207L00000X Anesthesiology (Licence: VA 0101246849) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2011-05-05 |