NPI | 1730421603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G23516) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G23516) |
Enumeration Date | 2013-03-19 |
Last Update Date | 2013-03-19 |