| NPI | 1013936715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX M3901) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: HI MD-13887) |
| 208100000X Physical Medicine & Rehabilitation (Licence: AL 27753) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX M3901) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-06-08 |