| NPI | 1811917396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A54188) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A54188) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2025-05-15 |