| NPI | 1861528259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 78187) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 20904) |
| 207L00000X Anesthesiology (Licence: MA L-224991) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-11-07 |