| NPI | 1295700599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA OS009250L) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS009250L) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA OS009250L) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2022-03-29 |