| NPI | 1336305473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NC 2009-01933) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 200901933) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 33338) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: SC 33338) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NC 33338) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2025-06-20 |