| NPI | 1417189812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 52936) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 52936) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 52936) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 52936) | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2020-08-03 |