| NPI | 1144200437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 32115) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MN 32115) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 31009) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-08-12 |