| NPI | 1477714400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME147391) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX H7851) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 60485) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA MD.201772) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA G88806) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CT 45041) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME147391) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2020-10-08 |