| NPI | 1134788953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0100095) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MT227637) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 4351044760) | |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-04-18 |