NPI | 1518256767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NY 202189) |
Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: NY 202189) |
204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 202189) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 202189) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 202189) | |
Enumeration Date | 2011-03-28 |
Last Update Date | 2018-06-06 |