| NPI | 1467512624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A91137) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A91137) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CA A91137) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CA A91137) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-04-26 |