| NPI | 1760579643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 72514) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TPME5614) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-06-26 |