| NPI | 1710920483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NH 16344) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TX L9171) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: TX L9171) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX L9171) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: TX L9171) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX L9171) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2013-12-17 |