| NPI | 1427080571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: PA MD044835L) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD044835L) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-04-03 |