| NPI | 1407979040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 54606) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 105492) |
| 207L00000X Anesthesiology (Licence: NH RT 1673) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-04 |