| NPI | 1205686680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 80243) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 34402) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-07-10 |