| NPI | 1457338477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 38240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME112219) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2020-08-04 |