| NPI | 1013326149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: KY 58512) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 59564) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2023-12-06 |