| NPI | 1245406776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 8637408-1204) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 38 2791823) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2023-06-21 |