| NPI | 1407351810 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 73379) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 60477) | 
| Enumeration Date | 2018-03-27 | 
| Last Update Date | 2023-08-25 |