| NPI | 1083635353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD477514) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: PA MD477514) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX K7977) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: PA MD477514) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX K7977) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD477514) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2023-02-01 |