| NPI | 1841935145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 87758) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 32490) |
| 207L00000X Anesthesiology (Licence: MN 74614) | |
| Enumeration Date | 2022-05-01 |
| Last Update Date | 2026-07-19 |