| NPI | 1619133444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA C164092) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01069861A) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01069861A) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2019-09-11 |