| NPI | 1811979362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO R9B74) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-19643) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |