| NPI | 1760019236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 31455) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30768) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2021-06-22 |