| NPI | 1669000568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 69748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30775) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2024-07-22 |