| NPI | 1417136755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NH 14506) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NH 14506) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2022-12-07 |