| NPI | 1194756601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 4003) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 26153) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-07-13 |