| NPI | 1356327522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV 6668) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA G75770) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 6668) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G75770) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2010-07-20 |