| NPI | 1316248206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 46572) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ R71032) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2024-02-15 |