| NPI | 1891080024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA OS016727) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NH RT-2731) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA OS016727) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2023-08-01 |