| NPI | 1831179530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 44674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME115039) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-08-03 |