| NPI | 1093911695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX P0229) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX P0229) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2021-05-27 |