| NPI | 1003311770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 73325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 0068738) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-08-07 |