| NPI | 1649481433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 2030) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: ME 2030) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME DO2030) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2022-02-18 |