NPI | 1376750612 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 35.096221) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD438381) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX N2502) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2022-11-29 |