| 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 |