| NPI | 1730345067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 57912) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 57912) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60295976) | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2020-11-10 |