| NPI | 1609814938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 32941) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 191354-1) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-07-21 |