| NPI | 1407945934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO R7G30) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MO R7G30) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-03-24 |