| NPI | 1134396492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A121016) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A121016) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A121016) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2026-06-14 |