| NPI | 1033393871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WV 25285) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 60267385) |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 068103) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101254060) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101254060) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0087846) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: WV 25285) | |
| 225100000X Physical Therapist (Licence: NY 029209) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2021-11-18 |