| NPI | 1295888022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A70365) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: CA A70365) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A70365) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2023-05-31 |