| NPI | 1194144329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 2020-01680) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: UT 11273908-1205) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-10-04 |