| NPI | 1013460708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 39939) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC Ll39939) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 39939) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2021-06-18 |