| NPI | 1497752760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 61336) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 37851) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 20422) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2024-11-08 |