| NPI | 1386817831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0084655) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2012005502) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MO 2012005502) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NV 15477) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 101263858) | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2018-11-26 |