NPI | 1275022113 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101025783) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101025783) |
Enumeration Date | 2018-05-07 |
Last Update Date | 2024-02-09 |