| NPI | 1548824394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 2023-00519) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NC 2023-00519) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2024-05-01 |