| NPI | 1558568501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 44149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5597) |
| 208100000X Physical Medicine & Rehabilitation (Licence: KS 9406909) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 44149) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2015-08-05 |