| NPI | 1447347950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A75933) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA A75933) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A75933) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2025-09-11 |