NPI | 1528140191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CO 48699) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 48699) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO 48699) | |
Enumeration Date | 2006-10-20 |
Last Update Date | 2019-03-15 |