| NPI | 1437341633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD438228) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD 438228) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA MD438228) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2024-03-05 |