| NPI | 1285670521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MT 10555) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MT 10555) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-04-05 |