| NPI | 1134460439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 5101020446) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101020446) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2024-06-20 |