| NPI | 1730740432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 67475) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8630) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2022-10-13 |