NPI | 1194713537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX J7778) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX J7778) |
Enumeration Date | 2005-10-10 |
Last Update Date | 2024-04-19 |