| NPI | 1659361715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO ME60622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO MDR5E55) |
| 207L00000X Anesthesiology (Licence: KS 0425840) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2007-07-08 |