| NPI | 1891843728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A92225) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A92225) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-02-07 |