| NPI | 1932633740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 64063) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 64063) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2020-08-24 |