| NPI | 1437252780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MS 34003) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 41433) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2025-01-10 |