| NPI | 1952634776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 053716) |
| 207L00000X Anesthesiology (Licence: MA 262686) | |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2022-07-21 |