| NPI | 1326135021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 28930) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 28930) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2013-07-15 |