| NPI | 1639063860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 83060) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 35159) |
| Enumeration Date | 2025-06-03 |
| Last Update Date | 2026-07-22 |