| NPI | 1912823220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 207L00000X) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 207LC0200X) |
| Enumeration Date | 2026-06-29 |
| Last Update Date | 2026-06-29 |