| NPI | 1871799528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 9161168-1205) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: UT 9161168-1205) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A112840) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2023-08-18 |