| NPI | 1326542945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: AZ 77746) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A164718) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A164718) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA A164718) | |
| 208VP0000X (Licence: CA A164718) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-10-15 |