| NPI | 1922324078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 2018-00941) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO DR0054763) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-06-09 |