| NPI | 1972633923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MS 20628) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY R0869) |
| 208D00000X General Practice (Licence: IN 01061022A) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101243394) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MS 20628) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MS 20628) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 20628) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MS 20628) | |
| 204R00000X Electrodiagnostic Medicine (Licence: MS 20628) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2016-03-02 |