| NPI | 1689645855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D53871) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D53871) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D53871) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D53871) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2020-06-14 |