| NPI | 1245545805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL 24694) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL 24694) |
| Enumeration Date | 2010-08-08 |
| Last Update Date | 2013-08-01 |