| NPI | 1669925756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TN 62341) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 62341) |
| 208D00000X General Practice (Licence: TN 62341) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110076) | |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2021-08-01 |