NPI | 1649899097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX U0821) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U0821) |
208100000X Physical Medicine & Rehabilitation (Licence: TX U0821) | |
Enumeration Date | 2020-04-15 |
Last Update Date | 2025-09-25 |