| NPI | 1356436745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 200400320) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NC 200400320) |
| 2085N0700X Radiology, Neuroradiology (Licence: NC 200400320) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-07-29 |