| NPI | 1245212810 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-20307) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO R7E25) | 
| Enumeration Date | 2005-11-18 | 
| Last Update Date | 2007-07-08 |