| NPI | 1043223381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA G76902) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: CA G76902) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA G76902) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2013-02-26 |