| NPI | 1275978876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 53494) |
| Additional Taxonomies | 208VP0000X (Licence: FL ME124991) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 53494) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL ME124991) | |
| 208D00000X General Practice (Licence: FL ME24991) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 53494) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2026-07-08 |