| NPI | 1003605718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 83058) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 35143) |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2026-07-15 |