| NPI | 1932256898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 65604) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD43940) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 43940) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-11-19 |