| NPI | 1639271331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 048820) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 048820) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2022-10-03 |