| NPI | 1568448629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 30431) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 73599) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2023-04-24 |