| NPI | 1881218659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 77275) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-11949) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2024-06-25 |