| NPI | 1376170118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 81856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX V1258) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-03-20 |