NPI | 1740500958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL DO1456) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL DO.1456) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 23604) | |
208100000X Physical Medicine & Rehabilitation (Licence: MS 23604) | |
Enumeration Date | 2010-06-10 |
Last Update Date | 2019-01-24 |