NPI | 1326242041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 1624) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NV DO1624) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2024-12-12 |