| NPI | 1316975527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 11485) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AL 00011485) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: AL 11485) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2010-03-01 |