| NPI | 1053105346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 83052) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 35140) |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2026-07-14 |