| NPI | 1215340500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A14738) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: CA 20A14738) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A14738) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2023-11-03 |