| NPI | 1215050299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA 20A6636) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: CA 20A6636) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-06-15 |