| NPI | 1275279770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A24934) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 20A24934) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A24934) | |
| Enumeration Date | 2022-05-07 |
| Last Update Date | 2026-07-15 |