NPI | 1346217585 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: SC 22310) |
Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: SC 22310) |
Enumeration Date | 2006-03-07 |
Last Update Date | 2009-06-24 |