| NPI | 1164648846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: PA OS006362E) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA 0S006362E) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2018-08-13 |