| NPI | 1548796642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101276118) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101276118) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101276118) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-11-26 |