| NPI | 1023303245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 59983) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 557751) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2024-11-12 |