| NPI | 1083664528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX M8793) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A94280) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX M8793) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A94280) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX M8793) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-01-20 |