| NPI | 1629063953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OK 17529) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F9385) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-07-08 |