NPI | 1700940541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 15286) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 15286) |
Enumeration Date | 2006-12-19 |
Last Update Date | 2014-04-11 |