| NPI | 1063495331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65066) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 33238) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2021-05-20 |