| NPI | 1710958962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 36620) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MN 36620) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2020-08-04 |