| NPI | 1225560030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 68497) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TPOS525) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-08-02 |