| NPI | 1639480254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 4937) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 13532) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2015-05-28 |