| NPI | 1992901219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A103353) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: HI MDR-5065) |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2016-04-04 |