| NPI | 1982644415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G88191) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA G88191) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2009-12-31 |