| NPI | 1467413427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PR 6661) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 225) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PR 357) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2010-09-07 |