| NPI | 1134107550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A72780) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA a72780) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A72780) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2024-02-08 |