| NPI | 1346247335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G11026) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G11026) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2014-01-16 |