| NPI | 1003800053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD071276L) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD071276L) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D56237) | |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MD D56237) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D56237) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD071276L) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101227545) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD D56237) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: PA MD071276L) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D56237) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2025-02-11 |