| NPI | 1740269398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 211157) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 211157) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2013-02-05 |