| NPI | 1932154192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 5101014670) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: MI 5101014670) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2026-04-21 |