| NPI | 1144458100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME 107153) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PR 15704) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301087534) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2021-12-28 |