| NPI | 1609611300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 80392) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 34352) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2025-07-30 |