NPI | 1346773520 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A22931) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX T1637) |
Enumeration Date | 2017-04-05 |
Last Update Date | 2025-09-12 |