| NPI | 1275022113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101025783) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101025783) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2024-02-09 |