| NPI | 1376777086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 56824) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 106894) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2013-09-18 |