| NPI | 1588759401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX H4562) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX H4562) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-08-21 |