| NPI | 1376596486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 24192) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200200223) |
| 207L00000X Anesthesiology (Licence: CO 42178) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2010-05-17 |