| NPI | 1750645685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 25047) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 56753) |
| 207L00000X Anesthesiology (Licence: AL 35192) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2021-09-17 |