| NPI | 1255478970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MO 104716) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 104716) |
| 204R00000X Electrodiagnostic Medicine (Licence: MO 104716) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MO 104716) | |
| 202C00000X Independent Medical Examiner (Licence: MO 104716) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-04-24 |