| NPI | 1447239793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D0078231) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0078231) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MD D0078231) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MD D0078231) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2019-04-09 |