| NPI | 1861584294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A108475) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A108475) |
| 208100000X Physical Medicine & Rehabilitation (Licence: ND 10251) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2024-07-08 |