| NPI | 1043265770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OK 18860) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OK 18860) |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: OK 18860) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OK 18860) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-04-29 |