| NPI | 1497825434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 206647) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 206647) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 206647) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-08-03 |