| NPI | 1467440883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A81278) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A81278) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CA A81278) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2023-06-08 |