| NPI | 1568751550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301099489) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: MI 4301099489) |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: MI 4301099489) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2022-04-01 |