NPI | 1124462056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: NV 16946) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NV 16946) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-22 |
Last Update Date | 2022-02-25 |