| NPI | 1205028149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PA MD441308) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD441308) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-07-09 |