| NPI | 1528521978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 67773) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 25477) |
| 207R00000X Internal Medicine (Licence: MN 30348) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2026-04-07 |