| NPI | 1588988224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A122667) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA a122667) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A122667) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2020-05-24 |