| NPI | 1740412576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 60858) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 52925) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2026-05-26 |