| NPI | 1275591364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D86533) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD D86533) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 207397) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MA 207397) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D86533) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 207397) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2019-08-05 |