NPI | 1326331885 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102204560) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0102204560) |
Enumeration Date | 2011-05-17 |
Last Update Date | 2024-11-12 |