| NPI | 1356451579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A53397) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: CA A53397) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA A53397) | |
| 208D00000X General Practice (Licence: CA A53397) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-04-12 |