NPI | 1235575879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 59773) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 59773) |
208VP0000X Pain Medicine, Pain Medicine (Licence: MN 59773) | |
Enumeration Date | 2013-05-21 |
Last Update Date | 2020-08-04 |