| NPI | 1386628758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 27290-020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2000146130) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2013-01-15 |