NPI | 1831197946 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD066786L) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD066786L) |
Enumeration Date | 2005-07-12 |
Last Update Date | 2016-07-13 |