| NPI | 1205832540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 45764) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 53603) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2013-12-27 |