| NPI | 1467718825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 56916) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 107038) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2020-08-04 |