NPI | 1972920270 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX R7352) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 3764) |
208VP0000X Pain Medicine, Pain Medicine (Licence: TX R7352) | |
208VP0000X Pain Medicine, Pain Medicine (Licence: TN 3764) | |
Enumeration Date | 2014-03-25 |
Last Update Date | 2024-06-07 |