| NPI | 1457935058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WI 86772) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 71945) |
| 207L00000X Anesthesiology (Licence: MN 71945) | |
| 207R00000X Internal Medicine (Licence: MN 31563) | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2026-07-30 |