| NPI | 1629060074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 62155) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 33835) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2022-03-19 |