| NPI | 1982270740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 71982) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 71982) |
| 207R00000X Internal Medicine (Licence: MN 31723) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2025-07-15 |