| NPI | 1023094810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 31599) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 19893) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-08-04 |