| NPI | 1588861710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS015735) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS015735) |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: PA OS015735) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-12-01 |