| NPI | 1730490426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 77116) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE TEP 6262) |
| 207L00000X Anesthesiology (Licence: MN 105664) | |
| 207L00000X Anesthesiology (Licence: MN 54607) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2022-10-12 |