| NPI | 1851682629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60375) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MN 60375) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2025-06-10 |