| NPI | 1730162801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0022088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0022088) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D0022088) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD Dd0022088) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2014-09-04 |