| NPI | 1962677724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A104871) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NY 245250) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CA 104871) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2012-03-15 |