NPI | 1063479327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 200001225) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NC 00669) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: SC 27854) | |
Enumeration Date | 2006-04-28 |
Last Update Date | 2021-09-03 |