| NPI | 1063479327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 200001225) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 00669) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: SC 27854) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2021-09-03 |