| NPI | 1528154192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: CA A65838) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A65838) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA A65838) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-03-15 |