| NPI | 1295884740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 31714) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 31714) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NC 31714) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 31714) | |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NC 31714) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 31714) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 31714) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2013-07-10 |