| NPI | 1023843505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 80627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 34428) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2025-08-21 |