| NPI | 1497382220 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A178290)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A178290)  | 
| Enumeration Date | 2020-03-23 | 
| Last Update Date | 2025-09-26 |