| NPI | 1659536639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 51946) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 51946) |
| Enumeration Date | 2008-07-19 |
| Last Update Date | 2020-10-26 |