| NPI | 1154739118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 7034821-021) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: WI 7034821-021) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WI 7034821-021) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2024-05-16 |