| NPI | 1043593098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 20A12283) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A12283) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A12283) | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2022-11-07 |