| NPI | 1629060694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA G52859) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G52859) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2009-04-23 |