NPI | 1992810790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A106547) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A106547) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A106547) | |
Enumeration Date | 2006-08-20 |
Last Update Date | 2019-10-14 |