| NPI | 1538528674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 20A19324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS15118) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2022-08-04 |