| NPI | 1023428919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PA MD463934) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD463934) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.136761) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35.136761) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: PA MD463934) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD463934) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2024-09-11 |