NPI | 1841276722 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 21658) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 21658) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 21658) | |
Enumeration Date | 2005-12-21 |
Last Update Date | 2019-05-28 |