| NPI | 1669567426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A96240) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A96240) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WI 46558-020) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 46558-020) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 36182) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 36182) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-02-22 |