| NPI | 1801864160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME77049) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME77049) |
| 174400000X Specialist (Licence: FL ME77049) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL ME77049) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2023-08-03 |