| NPI | 1205369444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 64155) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 28975) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2021-08-30 |