| NPI | 1508847039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 207496) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 207496) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA GO84237) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME11390) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ MA66719) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2023-03-07 |