| NPI | 1508894379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA G585140) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: CA G585140) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-07-08 |