| NPI | 1144277930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 9401375) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 9401375) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NC 9401375) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 9401375) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NC 9401375) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 9401375) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 9401375) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 9401375) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2023-01-20 |