| NPI | 1225125529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A82847) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A82847) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A82847) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2023-03-07 |