| NPI | 1366516734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS008710L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 1691) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2013-02-18 |