| NPI | 1861650913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD H0067867) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0102202684) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: DC DO034226) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2018-03-19 |