| NPI | 1386091122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 68764) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10497) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: IA R-10497) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA R-10497) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: IA R-10497) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA R-10497) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IA R-10497) | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2024-07-10 |