| NPI | 1992332985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 69581) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 69581) |
| 207R00000X Internal Medicine (Licence: MN 30778) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-07-01 |