| NPI | 1669541702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 51819) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MA12066000) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2024-01-05 |