NPI | 1073594693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: DE C1-0005467) |
Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: DE C1-0005467) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: DE C1-0005467) | |
Enumeration Date | 2005-11-10 |
Last Update Date | 2024-01-09 |