NPI | 1821044025 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA 08510R) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 032835) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2015-02-11 |