NPI | 1306047345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q9212) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX Q9212) |
208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q9212) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q9212) | |
Enumeration Date | 2007-05-29 |
Last Update Date | 2023-08-28 |