| NPI | 1316917461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 30943) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 19954) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-08-04 |