| NPI | 1881257855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 67906) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30257) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2024-01-18 |