| NPI | 1184787491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WA MD00049437) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: OR MD156621) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OR MD156621) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2021-08-12 |