| NPI | 1659324234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20a5941) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: ME 1820) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MA 60425) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: ME 1820) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MA 60425) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 1820) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20a5941) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 60425) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-03-07 |