| NPI | 1033173471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME100837) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD484898) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA MD484898) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 250059) | |
| 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: PA MD484898) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD484898) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2024-12-10 |