| NPI | 1235592478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A152948) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A152948) |
| 207P00000X Emergency Medicine (Licence: MA 278535) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2021-12-06 |