| NPI | 1306161963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A118512) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA CA118512) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA CA118512) | |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2023-03-14 |