| NPI | 1689600041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A51410) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA A51410) |
| 208VP0000X (Licence: CA A51410) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-01-17 |