NPI | 1588760011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD037864E) |
Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: PA MD-037864-E) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD037864E) | |
Enumeration Date | 2006-09-15 |
Last Update Date | 2023-08-04 |