| NPI | 1386624765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 42805) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 23453) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2022-07-11 |