| NPI | 1730387572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 55449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9406870) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2012-09-28 |