| NPI | 1285808014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 69174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 134950) |
| 207L00000X Anesthesiology (Licence: WA MD60125322) | |
| 207L00000X Anesthesiology (Licence: VA 0101268401) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2021-07-08 |