NPI | 1922532977 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 65387) |
Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: AZ 65387) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2024-09-20 |