| NPI | 1992169403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 67291) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD29832) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2025-10-14 |