NPI | 1588982144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MO 2017030452) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TN 804330) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 804330) | |
Enumeration Date | 2010-05-06 |
Last Update Date | 2018-09-24 |