| NPI | 1861623886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 27776) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 53018) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2016-05-18 |