| NPI | 1700807807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX P6398) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 36110569) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IN 01064540A) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX P6398) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: TX 8211) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2014-06-20 |