| NPI | 1518223411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: MD D89248) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: DC MD047429) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: GA 77739) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-06-10 |