| NPI | 1093797540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD H0071373) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB06306500) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2023-05-04 |