| NPI | 1417100918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NV DO1610) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA 11170) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA 20A11170) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX M9411) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2019-06-26 |