| NPI | 1467543447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 50644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 9651) |
| 207L00000X Anesthesiology (Licence: MN 50644) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-03-28 |