| NPI | 1518048156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0051789) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: NE 24467) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NE 24467) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: NE 24467) | |
| 208VP0000X Pain Medicine Pain Medicine (Licence: CO DR.0051789) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2024-08-01 |