| NPI | 1710672159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 77552) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 33410) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-08-09 |