| NPI | 1689899361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD431486) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0068680) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD431486) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0068680) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2024-05-17 |