| NPI | 1245324235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 7425) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 44631) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-10-03 |