| NPI | 1184055303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME152087) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME152087) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01083026a) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 53028) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 36.143746) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: WI 18382) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036143746) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: KY 53208) | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2024-04-08 |