NPI | 1821013962 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A88814) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A88814) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2019-09-27 |