NPI | 1255473575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A60900) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A60900) |
208100000X Physical Medicine & Rehabilitation (Licence: CA A60900) | |
Enumeration Date | 2007-02-13 |
Last Update Date | 2016-07-15 |