| NPI | 1326542945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A164718) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: CA A164718) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CA A164718) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A164718) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-01-26 |