| NPI | 1326061268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 020854) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: LA 020854) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-11-18 |