| NPI | 1932127768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME95990) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA 11047R) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA 11047R) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME95990) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-12-15 |