| NPI | 1316145675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 70139) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS014138) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA OS014138) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2023-03-29 |