| NPI | 1487944922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 37844) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 58917) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2019-02-15 |