| NPI | 1801850953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA G077865) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA G077865) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA G077865) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA G077865) | |
| 171100000X Acupuncturist (Licence: CA G077865) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-08-24 |