NPI | 1962428656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX M3662) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX M3662) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2024-04-16 |