NPI | 1487850699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0075112) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0075112) |
208100000X Physical Medicine & Rehabilitation (Licence: PA MD438069) | |
Enumeration Date | 2007-06-25 |
Last Update Date | 2022-07-27 |