| NPI | 1467740670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60754) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MN 60754) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2024-07-29 |