| NPI | 1356836654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65979) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL15116) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2020-08-24 |