| NPI | 1164495222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 39343) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MN 39343) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-04 |