| NPI | 1841276722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 21658) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 21658) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 21658) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2019-05-28 |