| NPI | 1801419247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD H0099857) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD H0099857) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL OS18606) | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-10-09 |