| NPI | 1669659793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NH 16634) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: NH 16634) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: MA 253233) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: DE C1-0009679) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2021-09-08 |