| NPI | 1356318232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA G27288) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G 27288) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CA G27288) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2011-03-22 |