| NPI | 1407030737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 82615) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 53966) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2024-04-02 |