| NPI | 1508151853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60465) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 60465) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2016-07-16 |