| NPI | 1659790533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 63632) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 65258) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-08-06 |