| NPI | 1306265582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65497) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 65497) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2019-07-29 |