NPI | 1619435625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA PTA49712) |
Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: CA PTA49712) |
Enumeration Date | 2019-03-08 |
Last Update Date | 2019-03-08 |