| NPI | 1518221902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60581) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS T-2602) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2020-08-04 |