| NPI | 1083317754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 77490) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 33321) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-07-05 |