| NPI | 1275709818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS11266) |
| Additional Taxonomies | 208VP0000X (Licence: FL OS11266) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS11266) | |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2025-02-11 |