| NPI | 1932150257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 20A4983) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A4983) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-04-26 |