| NPI | 1316971880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61185856) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WA MD61185856) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-143847) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD61185856) | |
| 207P00000X Emergency Medicine (Licence: IA 30343) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 345528) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101280393) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2026-06-17 |