| NPI | 1518371194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A148854) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A148854) |
| 207R00000X Internal Medicine (Licence: CA A148854) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2026-02-09 |