| NPI | 1225242332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A98906) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA A98906) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2018-03-17 |