NPI | 1447548961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX R0816) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R0816) |
Enumeration Date | 2011-07-18 |
Last Update Date | 2024-09-29 |