| NPI | 1184678534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 35578) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301516649) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2026-07-31 |