| NPI | 1750451258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA a97386) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA a97386) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA a97386) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-04-30 |