NPI | 1760825210 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 293785-01) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 293785-01) |
Enumeration Date | 2013-04-15 |
Last Update Date | 2020-07-22 |