| NPI | 1770829541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS13029) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: FL OS13029) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS13029) | |
| Enumeration Date | 2012-12-22 |
| Last Update Date | 2025-08-27 |