| NPI | 1427090539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A85179) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A851791) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-03-07 |