| NPI | 1225265770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 9407566) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 27249) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2010-08-10 |