| NPI | 1487898938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A124459) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A124459) |
| 207Q00000X Family Medicine (Licence: CA A124459) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2023-04-26 |