| NPI | 1629116009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MN 67665) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101015581) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-10-29 |