| NPI | 1528068921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: CT 043826) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CT 043826) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2016-09-28 |