| NPI | 1922027218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA g54189) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L1100) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-08-16 |