| NPI | 1083356166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 87519-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 74674) |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2026-08-24 |