| NPI | 1285731976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G68228) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G68228) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2011-07-13 |