| NPI | 1659357937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 36466) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 45484) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-12-28 |