| NPI | 1407483415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MN 76911) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 76911) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-06-25 |