| NPI | 1275634842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 34144) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN MN34144) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2010-10-18 |