| NPI | 1326242041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: NV 1624) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NV DO1624) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2024-12-12 |