| NPI | 1417144858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX N6266) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N6266) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: TX N6266) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX N6266) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX N6266) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N6266) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2018-10-10 |