NPI | 1982872990 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME106247) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME106247) |
208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME106247) | |
Enumeration Date | 2008-02-12 |
Last Update Date | 2022-01-28 |