| NPI | 1619955739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 44028) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MN 44028) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2021-12-08 |