| NPI | 1780910919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD H0072473) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD H0072473) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD H0072473) | |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2024-04-08 |