| NPI | 1700869096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NH 8091) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: NH 8091) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NH 8091) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2023-08-30 |