| NPI | 1972182459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A191388) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A191388) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2026-09-15 |