| NPI | 1821626870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0072791) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO DR.0072791) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-08-04 |