| NPI | 1336108372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: CA A83645) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A83645) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2025-09-11 |