| NPI | 1124190079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 54631) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A94696) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 054631) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 054631) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2021-05-03 |