| NPI | 1033154893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A53588) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A53588) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2025-09-11 |