| NPI | 1427342146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NM MD2018-0189) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2018-0189) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2025-10-20 |