| NPI | 1053631150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 62310) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0116022054) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2020-08-03 |