| NPI | 1336253665 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 4757) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 4271) | 
| 207P00000X Emergency Medicine (Licence: OK 4271) | |
| Enumeration Date | 2006-08-17 | 
| Last Update Date | 2010-10-27 |