NPI | 1063918506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A159364) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A159364) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-03 |
Last Update Date | 2023-06-09 |