| NPI | 1841722436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101026812) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 70358) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2025-05-16 |