| NPI | 1497215875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NE 2921) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IA DO-06292) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-08-06 |