| NPI | 1538173950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A86646) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 67636) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 67636) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A86646) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A86646) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-06-05 |