| NPI | 1154718815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 91780) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA 20A17403) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A17403) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A17403) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 20A17403) | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2022-08-25 |