| NPI | 1710330493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301501529) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301501529) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2024-09-24 |