NPI | 1508212093 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0091591) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0091591) |
Enumeration Date | 2016-05-13 |
Last Update Date | 2022-05-02 |