| NPI | 1033501671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NV DO2510) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL OS14361) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS14361) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV DO2510) | |
| 171100000X Acupuncturist | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NV DO2510) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS14361) | |
| 207Q00000X Family Medicine (Licence: NV DO2510) | |
| 207Q00000X Family Medicine (Licence: FL OS14361) | |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2022-02-03 |