| NPI | 1427219989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: GA 076319) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: LA 205571) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TN 49693) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2020-01-27 |