| NPI | 1841366465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX L5305) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX L5305) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2024-02-14 |