| NPI | 1144290222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 217236) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NH 11951) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NH 11951) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MA 217236) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2019-07-18 |