| NPI | 1437387545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MA 277266) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 56888) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MN 56888) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2019-01-31 |