| NPI | 1528004496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA G067802) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G67802) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NV 13914) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CA G067802) | |
| 207N00000X Dermatology (Licence: CA G067802) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2024-08-05 |