| NPI | 1225354921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 62279) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 54357) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2020-11-20 |