| NPI | 1811166770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX P8048) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX P8048) |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101259782) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.135093) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: LA MD.203006) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA MD.203006) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036171790) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA MD.203006) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX P8048) | |
| 208VP0000X (Licence: TX P8048) | |
| 208VP0000X (Licence: LA MD.203006) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NE 29054) | |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2025-09-30 |