| NPI | 1841470176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TN 3424) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102204152) |
| Enumeration Date | 2007-11-03 |
| Last Update Date | 2024-02-05 |