| NPI | 1154348464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 112047) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A79161) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2026-05-19 |