| NPI | 1700814555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 04-37608) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007011375) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2015-01-06 |