| NPI | 1891107397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 63317) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10005) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2018-07-24 |