| NPI | 1821309253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 49228) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 7510) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2014-07-25 |