| NPI | 1487884052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.123988) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: OR MD197637) |
| 208100000X Physical Medicine & Rehabilitation (Licence: OR MD197637) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2022-02-23 |