| NPI | 1730407917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS12315) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS12315) |
| 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: FL OS12315) | |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: FL Os12315) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL OS12315) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS12315) | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2023-03-07 |