| NPI | 1245257963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A6316) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA 20A6316) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-07-13 |