| NPI | 1669571634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 35203) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO DR.0033700) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CO DR.0033700) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-01-31 |