| NPI | 1962529578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 81654) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 50978) |
| 207L00000X Anesthesiology (Licence: MO 2010009850) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-01-20 |