NPI | 1033247218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PR 12268) |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: PR 12268) |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: PR 12268) | |
209800000X Legal Medicine (Licence: PR 12268) | |
Enumeration Date | 2007-03-01 |
Last Update Date | 2007-07-08 |