| NPI | 1992902670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A86587) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A86587) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2016-04-17 |