| NPI | 1932494788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65555) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 257446) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-01-18 |