| NPI | 1730341496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 61509) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2008018933) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 61509) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 61509) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2015-03-24 |