| NPI | 1013113935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A11085) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A110885) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-05-29 |