| NPI | 1184112526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NV 23937) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NV 23937) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A175847) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2025-06-09 |