| NPI | 1932196946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 34839) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX m6665) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TN MD34839) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2022-03-16 |