| NPI | 1003826983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WV 2602) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD H0055003) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD H0055003) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-04-07 |