| NPI | 1447208087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: GA 035868) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 035868) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CO 0044914) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-10-10 |