| NPI | 1184155228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: DC MD210011926) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0097216) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD471751) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101278439) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: DE C1-0026281) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-09-19 |