| NPI | 1245225226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD H0045795) |
| Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: MD H0045795) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD H0045795) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD H0045795) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: MD H0045795) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2025-11-05 |