| NPI | 1336254218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NM MD2006-0166) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM MD2006-0166) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2014-07-26 |