| NPI | 1144480989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101254093) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101254093) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101254093) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: VA 0101254093) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-03-02 |