| NPI | 1497861363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 007557) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 5343817-1204) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-05-02 |