| NPI | 1093942252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AR E-8744) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A126037) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2019-01-11 |