| NPI | 1306934179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 72674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 41755) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MN 72674) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: WI 41755) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-02-20 |