| NPI | 1174543805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 9801049) |
| Additional Taxonomies | 2084N0600X (Licence: NC 9801049) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 9801049) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NC 9801049) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-09-20 |