| NPI | 1629496112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 21208) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 65705) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2021-09-18 |