| NPI | 1922397082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NH RT-3202) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC mtl000998) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208D00000X General Practice (Licence: CA A128449) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2021-12-17 |