| NPI | 1447512157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS016915) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA OS016915) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA OS016915) | |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2022-03-30 |