| NPI | 1770570442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A92212) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A92212) |
| 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: CA A92212) | |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: CA A92212) | |
| 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: CA A92212) | |
| 2081P0301X Physical Medicine & Rehabilitation Brain Injury Medicine (Licence: CA A92212) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA A92212) | |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: CA A92212) | |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2019-08-09 |