| NPI | 1487686119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 198829) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 198829) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2010-01-27 |