| NPI | 1457581811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 9407295) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407295) |
| 207P00000X Emergency Medicine (Licence: AR E-8135) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2014-12-10 |