| NPI | 1356535884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NC 2025-01703) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01070774A) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NC 2025-01703) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IN 01070774A) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2025-01703) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2025-08-29 |