| NPI | 1730169707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101268477) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 34116) |
| 171100000X Acupuncturist | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 34116) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 34116) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-07-21 |