| NPI | 1073815163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CO DR.0070097) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD60657280) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: VA 0101252225) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: WA MD60657280) | |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2023-01-27 |