| NPI | 1366854226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A153895) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 66143) |
| 207L00000X Anesthesiology (Licence: KS 9408317) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-01-08 |