| NPI | 1336670736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 64142) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 28973) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-08-25 |