| NPI | 1215941158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G64292) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA g64292) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA g64292) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-07-28 |