| NPI | 1386693653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301084855) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: AR E1201) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MI 4301084855) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MI 4301084855) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2013-01-16 |