| NPI | 1558331108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 22753) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 47520) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2009-12-01 |