NPI | 1952374043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME110649) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME110649) |
Enumeration Date | 2006-02-09 |
Last Update Date | 2020-08-28 |