| NPI | 1417936519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 46786) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 46786) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2009-03-04 |