| NPI | 1326363300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A11914) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA 20A11914) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2018-08-16 |