NPI | 1275571010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: CA A72729) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A72729) |
2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA A72729) | |
208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A72729) | |
Enumeration Date | 2006-06-03 |
Last Update Date | 2022-08-01 |