| NPI | 1992060891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 61041) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT202690) |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2019-10-29 |