| NPI | 1407380405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 64156) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 28976) |
| 207R00000X Internal Medicine (Licence: MN 28624) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2021-10-26 |