| NPI | 1649363284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 51248) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH RT 1390) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-01-04 |