| NPI | 1043231756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD474718) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PA MD474718) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD474718) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: WI 43981) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD474718) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-12-22 |