| NPI | 1558337154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 27854) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 27854) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2022-07-14 |