| NPI | 1831503408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 75541) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 286078) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2023-10-27 |