| NPI | 1770785347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 2020-04476) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A100536) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A100536) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2021-07-20 |