| NPI | 1750417283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 261427) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS11361) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 261427) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL OS11361) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS11361) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2014-05-13 |