| NPI | 1235660465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 76791) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 64555) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-07-05 |