| NPI | 1205919008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA C51983) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA C51983) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA C51983) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA C51983) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2022-07-21 |