| NPI | 1225101553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101251219) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0101251219) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: VA 0101251219) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2012-07-05 |