| NPI | 1326045642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 8003) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: SC 8003) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2017-02-20 |