| NPI | 1407804883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 0427896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO R9N71) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-07-09 |