| NPI | 1437186467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G71850) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA G71850) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2024-07-17 |