NPI | 1821050931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0081417) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MD427317) |
Enumeration Date | 2006-04-04 |
Last Update Date | 2016-06-21 |