| NPI | 1639758097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 71846) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 32393) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2022-07-01 |