| NPI | 1740509645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2014009352) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0537123) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2014-07-26 |