| NPI | 1699192286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A16385) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA 20A16385) |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2025-03-13 |