| NPI | 1457694887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA C185701) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IL 036.158810) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: GA 080672) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2024-01-04 |