NPI | 1184112526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NV 23937) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NV 23937) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A175847) | |
Enumeration Date | 2018-05-01 |
Last Update Date | 2025-06-09 |