NPI | 1639483969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS14281) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q3271) |
Enumeration Date | 2010-07-28 |
Last Update Date | 2023-05-25 |