| NPI | 1376642900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01040129A) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 336-077840) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01040129A) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-03-17 |