| NPI | 1427365428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CT 55788) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS 13416) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS13416) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CT 55788) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 55788) | |
| Enumeration Date | 2010-09-12 |
| Last Update Date | 2017-01-13 |