| NPI | 1801328901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: UT 12236678-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 12236678-1205) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 294246) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2024-08-26 |