| NPI | 1376584540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A70723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A70723) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2018-07-31 |