NPI | 1619907433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN DO2014) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 2014) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2023-10-26 |