| NPI | 1184835613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: AZ 005906) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 005906) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 005906) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AZ 005906) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2024-03-01 |