| NPI | 1609627090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 80382) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 34439) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2025-07-30 |