NPI | 1770544454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 24642) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 24642) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2016-06-07 |