| NPI | 1821558743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 81271) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 67860) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-01-22 |