| NPI | 1215922935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G50821) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G508210) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2015-03-23 |