| NPI | 1629358031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 78057) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 78057) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2025-01-28 |