| NPI | 1134652704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12058320-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 28960) |
| 207L00000X Anesthesiology (Licence: MN 64098) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2021-10-26 |