| NPI | 1124083233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 52166) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 49247) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2016-03-24 |