| NPI | 1215295548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA 138237) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 01076211A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01076211A) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: IN 01076211A) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2021-04-21 |