| NPI | 1063844470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 63999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 9204964-1205) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2020-06-22 |