| NPI | 1013365154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A172486) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A172486) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2025-05-29 |