| NPI | 1952500134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 50147) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO DR.0050147) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2023-03-07 |