| NPI | 1043387624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TN MD0000012878) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TN MD0000012878) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: TN MD0000012878) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-10-28 |