| NPI | 1952690570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NV 19299) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q9571) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NV 19299) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX Q9571) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2023-08-02 |