| NPI | 1437160934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX J4456) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX J4456) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2013-01-23 |