| NPI | 1508942046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 190271) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: NY 190271) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-01-04 |