| NPI | 1619362084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO DR.0065176) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OR MD192439) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2021-07-16 |