| NPI | 1316477235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A171579) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A171579) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-09-03 |