NPI | 1538235502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO 46857) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 46857) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2011-08-12 |