| NPI | 1427535202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301507428) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301507428) |
| 208VP0000X (Licence: MI 4301507428) | |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2025-10-07 |