NPI | 1396948956 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WA MD60252648) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD60252648) |
Enumeration Date | 2007-06-08 |
Last Update Date | 2021-05-04 |