| NPI | 1225692874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A176390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A176390) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2023-11-03 |