NPI | 1477563369 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME115817) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A105673) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A105673) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: DE C1-0007425) | |
Enumeration Date | 2006-08-09 |
Last Update Date | 2017-10-18 |