| NPI | 1831519651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A150206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A150206) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A150206) | |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2025-12-20 |