NPI | 1235226143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 51406) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WI 51406) |
208100000X Physical Medicine & Rehabilitation (Licence: WI 51406) | |
Enumeration Date | 2006-10-10 |
Last Update Date | 2012-02-23 |