| NPI | 1932604477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65881) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 29175) |
| 207L00000X Anesthesiology (Licence: TN 66155) | |
| 207R00000X Internal Medicine (Licence: MN 29175) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-09-27 |