| NPI | 1235193558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX J3882) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J3882) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX J3882) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2008-01-11 |