| NPI | 1316202138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01078881A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301101477) |
| 208100000X Physical Medicine & Rehabilitation (Licence: AZ 52154) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 01078881A) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2025-01-09 |