| NPI | 1396800488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A121616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188153) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-05-07 |