| NPI | 1932129400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TN md31865) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN md31865) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2016-04-04 |