| NPI | 1871525634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 2951) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: AZ 2951) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 2951) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-01-17 |