| NPI | 1467485730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A98702) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A93702) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A93702) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2017-08-18 |