| NPI | 1790873545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA C54364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C54364) |
| 208VP0000X (Licence: CA C54364) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-08-24 |