| NPI | 1275010720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 75955) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301509188) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2024-03-17 |