| NPI | 1417900309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: WA OP00001987) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010299) |
| 171100000X Acupuncturist (Licence: WA OP00001987) | |
| 207L00000X Anesthesiology (Licence: WA OP00001987) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA OP00001987) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA OP00001987) | |
| 207Q00000X Family Medicine (Licence: WA OP00001987) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-07-16 |