| NPI | 1740236280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G65019) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G65019) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G65019) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2014-03-25 |