| NPI | 1609371236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65804) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29120) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-01-22 |