| NPI | 1265498778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 52689-20) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.087860) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-139526) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036-139526) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 52689-20) | |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2021-08-05 |