| NPI | 1336275718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 52216) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME115070) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-10-15 |