| NPI | 1255342119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 75263) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 49330) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-09-01 |