| NPI | 1578721403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 69073) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: WI 69073) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 69073) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2024-04-23 |