| NPI | 1295034866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: HI DOS 1685) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA 20A13327) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: HI DOS 1685) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2017-04-01 |