NPI | 1992147029 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2019-01947) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL UO3440) |
208100000X Physical Medicine & Rehabilitation (Licence: FL OS13352) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 82190) | |
Enumeration Date | 2013-07-17 |
Last Update Date | 2024-02-22 |