NPI | 1346295920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX N2070) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 057456) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2023-07-10 |