| NPI | 1467672485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA C159408) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D77403) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D77403) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-12-12 |