| NPI | 1689939860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 78502) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 29977) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A139306) | |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2025-01-03 |