| NPI | 1710419080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A173601) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 28965) |
| 207L00000X Anesthesiology (Licence: MN 64112) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-08-04 |