| NPI | 1144209057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 37088) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 37088) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 37088) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME87405) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2024-01-05 |