| NPI | 1093769614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME146438) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME146438) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA8027500) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD074300L) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD-074300-L) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-05-14 |