| NPI | 1992297055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 77671) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-11270) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-09-12 |