| NPI | 1326063389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G53496) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA G53496) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-03-14 |