| NPI | 1376869917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 62920) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 56919-20) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2018-03-17 |