NPI | 1972999753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D89189) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0089189) |
Enumeration Date | 2015-04-08 |
Last Update Date | 2024-10-24 |