| NPI | 1588227946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME159150) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA 61430849) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A193332) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61430849) | |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2025-04-15 |