| NPI | 1730147273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 2017-02039) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS012427) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NC 2017-02039) | |
| 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: NC 2017-02039) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: PA 2017-02039) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-03-10 |