NPI | 1033120852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101268046) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11013088) |
207QS0010X Family Medicine, Sports Medicine (Licence: MN 55415) | |
207QS0010X Family Medicine, Sports Medicine (Licence: VA 0101268046) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 54712) | |
Enumeration Date | 2006-08-10 |
Last Update Date | 2020-08-03 |