NPI | 1720548159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NH 25271) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25MA11770000) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-21 |
Last Update Date | 2024-05-29 |