| NPI | 1881614352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A43907) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A43907) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-02-26 |