| NPI | 1407146301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS 12571) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS12571) |
| 208VP0000X (Licence: FL OS12571) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS12571) | |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2026-06-15 |