| NPI | 1528123072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: SC 29727) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 29727) |
| 208100000X Physical Medicine & Rehabilitation (Licence: SC 29727) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: SC 29727) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 29727) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-03-11 |