| NPI | 1003348590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 326174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 64414) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2021-10-26 |