| NPI | 1730192915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME107418) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01059597A) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D65804) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME107418) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME107418) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL ME107418) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-11-25 |