NPI | 1134339799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AL 27872) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 27872) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2022-07-21 |