| NPI | 1548420979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 51290) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 81907) |
| 207L00000X Anesthesiology (Licence: MN 103916) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2025-02-27 |