NPI | 1093150963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A132634) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A132634) |
Enumeration Date | 2013-05-06 |
Last Update Date | 2021-02-23 |