| NPI | 1154933281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA 91001) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VT 042.0015210) |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2023-02-14 |