| NPI | 1013954130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A50680) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA A50680) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-11-04 |