| NPI | 1083780597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A84920) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A84920) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2024-08-12 |