| NPI | 1437243680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2006-01286) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NC 2006-01286) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 2006-01286) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-12-18 |