| NPI | 1376073304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 66107) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 28980) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-07-21 |