| NPI | 1366404907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 38924) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 12976) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2019-05-15 |