| NPI | 1346457751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX Q1450) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.089741) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OH 35.089741) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX Q1450) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-09-14 |