| NPI | 1164593208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 48173-020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 49990) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2009-08-17 |