| NPI | 1417584335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 79872) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 91927) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2025-09-23 |