| NPI | 1255759726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 59835) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 1255759726) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2018-04-17 |