| NPI | 1023263282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A128033) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A128033) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2015-07-23 |