| NPI | 1346565280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 20A14068) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA 20A14068) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A14068) | |
| Enumeration Date | 2010-04-04 |
| Last Update Date | 2024-12-05 |