| NPI | 1952338279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX H9570) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX H9570) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-10-17 |