| NPI | 1033159132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MI 5101007564) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101007564) |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: MI 5101007564) | |
| 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: MI 5101007564) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: MI 5101007564) | |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: MI 5101007564) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: MI 5101007564) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MI 5101007564) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-07-03 |