| NPI | 1194722611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA C52023) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA C52023) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2015-12-21 |