NPI | 1396944740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: NV 13659) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NV 13659) |
Enumeration Date | 2007-07-16 |
Last Update Date | 2019-09-04 |