| NPI | 1396836789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD037165E) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 200100756) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: PA MD037165E) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2015-04-03 |