| NPI | 1972617595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 20634) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101242167) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-08-16 |