| NPI | 1073957932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA A136211) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: CA A136211) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2021-05-12 |