| NPI | 1700022647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0000X Registered Nurse, Pain Management (Licence: CA NP 15570) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: CA RN 653790) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2023-03-07 |