| NPI | 1194888537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME76613) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 9743) |
| 207L00000X Anesthesiology (Licence: VT 042-0010340) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-09 |