| NPI | 1851367718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NM MD2018-0581) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CA G67480) |
| 208600000X Surgery (Licence: CA G67480) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CA G67480) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-04-18 |